Hearing Aids: Types, How They Work, and How to Choose the Right One
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What are hearing aids?
Hearing aids are small electronic devices worn behind or inside the ear that make sounds louder so people with hearing loss can hear and follow speech more easily. They cannot restore natural hearing. An audiologist tests your hearing first, then helps you choose prescription or over-the-counter devices, which usually last six to seven years. [1]
What the research says
Hearing aids clearly improve everyday hearing and quality of life. A review of 5 randomized trials (825 adults with mild to moderate hearing loss) found a large improvement in hearing-related quality of life — about 26 points better on a 100-point hearing-handicap scale — plus a large gain in listening ability and a small gain in overall quality of life. (Ferguson et al., Cochrane Database Syst Rev, 2017) [2]
The effect on memory and thinking is still being studied. In a trial of 977 adults aged 70–84, hearing aids plus counseling did not slow 3-year cognitive decline in the group as a whole, but a planned sub-analysis suggested a benefit in older adults already at higher risk of decline. (Lin et al., Lancet, 2023) [3]
About 4 in 10 people who own hearing aids don't use them. Pooling 21 studies (12,696 people) showed about 62% used their devices; the most common reasons for stopping were not noticing a benefit and discomfort. (Marcos-Alonso et al., J Clin Med, 2023) [4]
Key takeaways
Hearing aids make sound louder; they don't cure hearing loss.
Every hearing aid has three basic parts: microphones, an amplifier and a speaker.
Common styles are BTE, RITE, ITE and ITC.
OTC hearing aids suit mild to moderate hearing difficulty; prescription aids are fitted and adjusted by an audiologist.
Expect a few months of adjustment — and don't give up if they feel strange at first.
How do hearing aids work?
Hearing aids work by picking up sound, turning it into an electrical signal, making that signal stronger and sending it into your ear. The details vary by model, but the basic path is the same: [1]
Microphones pick up sound and turn the sound waves into electrical signals.
The signals are processed and sent to an amplifier.
The amplifier makes the signals louder.
A tiny speaker (receiver) delivers the boosted sound into your ear.
Some hearing aids use disposable batteries, but most are rechargeable. You charge them much like a smartphone. [1]
What are the different types and styles of hearing aids?
Hearing aids come in two main types — prescription and over-the-counter (OTC) — and in several styles that sit in different places on or in the ear. Some styles are easy to notice, while others are hard to see. [1]
Style | Short name | Where it sits |
Behind-the-ear | BTE | Main body rests behind the ear |
Receiver-in-the-ear | RITE | The speaker (receiver) sits inside the ear |
In-the-ear | ITE | Sits in the ear itself |
In-the-canal | ITC | Sits in the ear canal |
An audiologist (a hearing care specialist) can help you find the style and fit that work best for you. [1]
For people whose hearing loss can't be helped by standard hearing aids, other devices exist, such as a bone-anchored hearing aid or a cochlear implant.
What is the difference between OTC and prescription hearing aids?
The main difference between OTC and prescription hearing aids is who sets them up: you adjust OTC hearing aids yourself, while an audiologist chooses, customizes and tests prescription hearing aids for you. [1]
Over-the-counter (OTC) | Prescription | |
Who it suits | Mild to moderate hearing difficulty | Customized to your hearing prescription |
Exam needed? | No exam or prescription (adults 18+ in the U.S.) | Yes — hearing test and hearing aid evaluation |
Settings | You adjust them yourself | Audiologist customizes and tests them |
Where to buy | Pharmacies, big-box stores, online | From your audiologist |
Follow-up care | You manage them on your own | Audiologist provides ongoing follow-up |
If OTC hearing aids aren't helping enough, it may be time to see an audiologist for prescription devices. [1] For official U.S. guidance, see the NIDCD guide to OTC hearing aids.
How do you get fitted for hearing aids?
Getting hearing aids starts with a hearing test, usually followed by a separate hearing aid evaluation with an audiologist. [1]
Referral: Your primary care doctor or an ear, nose and throat (ENT) specialist can refer you, though some audiologists see patients without a referral.
Hearing test: Shows whether you have hearing loss and whether hearing aids could help.
Evaluation and fitting: For prescription aids, the audiologist helps you choose a device, customizes the settings and checks that it meets your prescription.
Tip: Getting your ears cleaned before the test can help the audiologist assess your hearing without delays. If wax is a problem, read about earwax blockage.
How long do hearing aids last?
Most people can use the same hearing aids for six to seven years. [1] Because your hearing can change, a yearly hearing test is recommended, and your audiologist can reprogram your existing devices instead of replacing them.
What are the benefits of hearing aids?
The main benefit of hearing aids is easier hearing and understanding of speech, which helps you take part more fully in daily life. [1]
Clearer conversations: They turn up the volume on the voices you want to hear.
Less background noise: Many models have features that reduce unwanted sounds.
Tinnitus relief: By amplifying the sounds you want, hearing aids may ease ringing in the ears over time, and some prescription models are designed for tinnitus.
Social and mental health: Better hearing can reduce social isolation and depression by making it easier to connect with others.
Brain health: Better hearing may help keep thinking sharp, which matters most for people at higher risk of dementia as they age. [1][3]
What is it like to get used to hearing aids?
Getting used to hearing aids can take several months, and a few small problems at the start are normal. [1]
What you may notice | Why it happens | What to do |
Your own voice sounds too loud | The microphones pick up your voice along with others | Keep wearing them; most people adapt within the first couple of weeks |
Whistling or buzzing (feedback) | The device may need cleaning, adjusting or better placement | Ask your audiologist to check the fit and settings |
Trouble hearing in noisy places | Loud, busy settings are hard even with typical hearing | Ask whether background noise can be turned down |
The most important rule: don't give up. If your hearing aids don't feel right, contact your audiologist to fine-tune them rather than putting them in a drawer. [1]
How do you care for hearing aids?
Caring for hearing aids mainly means protecting them from damage and keeping them charged and checked. [1]
Apply hairspray and other personal care products before putting your hearing aids in.
Keep them away from extreme heat or cold, moisture, children and pets.
Replace or recharge dead batteries.
Turn them off when you're not using them.
See your audiologist at least once a year to adjust prescription hearing aids.
When should you call your audiologist?
Call your audiologist whenever you have questions about using or caring for your hearing aids, or if they aren't helping enough. See a doctor promptly instead if you have sudden hearing loss, ear pain, fluid draining from the ear or new dizziness. [1] The settings may simply need fine-tuning. If OTC devices aren't working for you, an audiologist can assess whether prescription hearing aids are a better fit.
Can a deaf person hear with a hearing aid?
Whether a deaf person can hear with a hearing aid depends on the cause and severity of the hearing loss. [1] A hearing aid won't help if the structures of the inner ear are severely damaged. In that case, a cochlear implant or other treatment may be more suitable. Some types of conductive hearing loss are treated with surgery such as stapedectomy.
Conclusion
Hearing aids can't restore natural hearing, but they make the sounds that matter louder and clearer. Strong research shows they improve listening ability and quality of life for adults with mild to moderate hearing loss. [2] Many people who could benefit never use them — often because hearing loss creeps in slowly and its impact goes unnoticed. A hearing test is the first step, and patience during the first few months is what turns a new device into a daily habit.
Think you might have hearing loss? Start with our guide to hearing loss symptoms, causes and treatment, then book a hearing test with an audiologist. Bring this article to your appointment to help you ask the right questions.
FAQ
What are hearing aids?
Hearing aids are small electronic devices worn behind or inside the ear that make sounds louder. They help people with hearing loss hear and understand speech more easily, but they cannot restore natural hearing.
Do I need a prescription for hearing aids?
Not always. In the U.S., adults 18 and older can buy OTC hearing aids without an exam or prescription, which may suit mild to moderate hearing difficulty. Prescription hearing aids are chosen and customized by an audiologist.
How long do hearing aids last?
Most people can use the same hearing aids for six to seven years. A yearly hearing test lets your audiologist reprogram them as your hearing changes.
Can hearing aids help with tinnitus?
Yes, they can for some people. By amplifying the sounds you want to hear, hearing aids may reduce ringing in the ears over time, and some prescription models are designed specifically for tinnitus.
How long does it take to get used to hearing aids?
It can take several months to fully adjust. Most people get used to the sound of their own voice within the first couple of weeks of consistent use.
Why does my hearing aid whistle?
Whistling or buzzing usually means the hearing aid needs cleaning or adjusting, or it isn't placed correctly in your ear. Your audiologist can check the fit and settings.
Do hearing aids prevent dementia?
Not proven. Better hearing may help keep thinking sharp, but a large trial found hearing aids did not slow cognitive decline in older adults overall, with a possible benefit only in those already at higher risk.
What if hearing aids don't help me?
Contact your audiologist first, because the settings may need fine-tuning. If inner-ear damage is severe, other options such as a cochlear implant may work better.
Does insurance cover hearing aids?
Coverage varies. Original Medicare does not cover hearing aids, though some Medicare Advantage and private plans do. Check with your plan before you buy.
How do I take care of my hearing aids?
Keep hearing aids dry, clean them often to remove earwax and take them out before showering or swimming. Store them safely and charge or change batteries as directed.
Related Reading
Auditory-Verbal Therapy: How It Helps Children Listen and Speak explains auditory-verbal therapy.
References
Cleveland Clinic. Hearing Aids: Types & How They Work. Cleveland Clinic. Last updated June 25, 2025. https://my.clevelandclinic.org/health/treatments/24756-hearing-aids
Ferguson MA, Kitterick PT, Chong LY, et al. Hearing aids for mild to moderate hearing loss in adults. Cochrane Database Syst Rev. 2017;9(9):CD012023. PMID 28944461. https://doi.org/10.1002/14651858.CD012023.pub2
Lin FR, Pike JR, Albert MS, et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. Lancet. 2023;402(10404):786-797. PMID 37478886. https://doi.org/10.1016/S0140-6736(23)01406-X
Marcos-Alonso S, Almeida-Ayerve CN, Monopoli-Roca C, et al. Factors Impacting the Use or Rejection of Hearing Aids-A Systematic Review and Meta-Analysis. J Clin Med. 2023;12(12):4030. PMID 37373724. https://doi.org/10.3390/jcm12124030
Disclaimer
This article is for general education only and is not a substitute for professional medical advice, diagnosis or treatment. Always talk to a qualified healthcare provider or audiologist about your hearing.
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